This is a collaborative post.
It is easy to be overwhelmed when your health care provider suggests that you start using vaginal dilators, but where to begin? There are so many choices online- do I need the plastic ones or ones made of silicone?
Let’s take a step back and talk about dilators. Exactly what are they?
Vaginal dilators, also known as vaginal trainers, are cylindrical, phallic shaped devices. Like a dildo, but not anatomically correct. They can be very small, like the size of a women’s pinky, and gradually progress up in size to that of large erect penis. Dilators usually come in pastel colors, designed this way so they are not intimidating to the user. They can be made of a hard plastic, or a flexible silicone material: this is where the main difference lies.
You may be thinking, who can benefit from progressive vaginal dilation therapy?
If you have experienced painful intercourse (known as dyspareunia), then dilators may be very helpful to you. The cause of this painful intercourse may be from vaginismus, the side effects of cancer treatments such as radiation and/or chemotherapy, or thinning and dryness of the vaginal tissue as a result of low estrogen levels from menopause. Transgender women, after the creation of a neo-vagina, and women suffering from other pelvic pain conditions, may also need dilators. Even if you are no longer interested in sexual intercourse, dilator therapy is still important as it help keep the vaginal tissue more elastic, so that a through pelvic exam can be painlessly performed. Dilators are designed to help your vaginal tissue gradually stretch and they help to bring improved blood flow to the pelvic tissue.
You should always start with the largest size dilators that you can insert fairly comfortably. Discomfort is ok, but pain is not. Your goal should be to dilate up to the size of your partner. This helps with the mind-body connection, giving you confidence that you can accommodate your partner’s penis.
You and your health care provider have agreed that dilators would be very helpful to you, and hopefully your health care professional has given you some advice on which dilators they want you to purchase. If not, this is where the confusion may arise.
For most of the above situations where you may be experiencing sexual pain, the silicone dilators may be your best option.
Silicone dilators resemble body tissue and are flexible and resilient. They can also be used warmed or chilled, just by running them under water. They are much softer than plastic dilators, allowing for a more gentle and comfortable insertion. Silicone is also very long lasting and durable, and there are more size options available in the silicone material. Silicone is non-porous, which makes them very easy to clean. They can be washed in warm soapy water and can even be placed in the dishwasher, or placed in boiling water. Just make sure you purchase a dilator with a smooth shaft. Some companies engrave their name on the dilator shaft, which makes them harder to clean.
However, there are situations that call for a more rigid plastic dilator. If you are working with a pelvic floor physical therapist, they may recommend this option. Hard plastic dilators can be less expensive than silicone dilators, especially is they are manufactured outside the United States. The hard plastic dilators are also easy to clean. These dilators are helpful to address trigger points, and in situations that require a hard inflexible dilator, such when scar tissue has formed or to prevent scar tissue formation. Women that have undergone surgery to create a neo-vagina are in this category and would benefit from a hard plastic dilator, especially ones with a slight curve. In addition, some gynecological oncologists will try to break up adhesions and scar tissue with a rigid plastic dilator. This tissue may have formed after pelvic surgery or radiation therapy.
Whichever dilator set you choose, remember to be patient and consistent with your progressive dilation therapy. Progress may be gradual but with regular use should be able to achieve your goal of painless intercourse and/or a painless pelvic exam.